Archivos de Bronconeumologia (http: www.archbronconeumol.org) publishes original studies whose content is based upon results dealing with several aspects of respiratory diseases such as epidemiology, pathophysiology, clinics, surgery, and basic investigation. Other types of articles such as reviews, editorials, special articles, clinical reports, and letters to the Editor are also published in the Journal. It is a monthly Journal that publishes a total of 12 issues, which contain these types of articles to different extents. All manuscripts are sent to peer-review and handled by the Editor or an Associate Editor from the team. The Journal is published both in Spanish and English. Therefore, the submission of manuscripts written in either Spanish or English is welcome. Translators working for the Journal are in charge of the corresponding translations. Manuscripts will be submitted electronically using the following web site: http://ees.elsevier.com/arbr, link which is also accessible through the main web page of Archivos de Bronconeumologia. See more
Access to any published article, in either language, is possible through the Journal web page as well as from Pubmed, Science Direct, and other international databases. Furthermore, the Journal is also present in Twitter and Facebook.

CiteScore measures average citations received per document published. Read more

CiteScore 2017

0.73

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR

0.366

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

Table 3. Comparison of the Characteristics of Patients Who Satisfied the Definition of the Chosen Frequent Exacerbator Patient and Those of the Other Patients With Bronchiectasis.

Table 4. Cox Regressions Using Different Combinations of Multidimensional Severity Scores as Independent Variables to Evaluate the Initial Severity of Bronchiectasis, and the Selected Definition of Frequent Exacerbator Patient.

Table 5. Distribution of Patients With Frequent Exacerbation, Using the Selected Definition, and Associated Mortality According to the Severity (Mild, Moderate or Severe) Evaluated by the BSI, FACED, and E-FACED Scores.

Show moreShow less

Abstract

Introduction

Bronchiectasis is a very heterogeneous disease but some homogeneous groups with similar clinical characteristics and prognosis have been identified. Exacerbations have been shown to have a negative impact on the natural history of bronchiectasis. The objective of this study was to identify the definition and characteristics of the “frequent exacerbator patient” with the best prognostic value and its relationship with the severity of bronchiectasis.

Methods

A historical cohort of 651 patients diagnosed with bronchiectasis was included. They had all received 5 years of follow-up since their radiological diagnosis. Exacerbation was defined as a worsening of the symptoms derived from bronchiectasis that required antibiotic treatment. The main outcome was all-cause mortality at the end of follow-up.

Results

The mean age was 48.2 (16) years (32.9% males). 39.8% had chronic infection by Pseudomonas aeruginosa. Mean BSI, FACED, and E-FACED were 7 (4.12), 2.36 (1.68), and 2.89 (2.03), respectively. There were 95 deaths during follow-up. The definition of the “frequent exacerbator patient” that presented the greatest predictive power for mortality was based on at least two exacerbations/year or one hospitalization/year (23.3% of patients; AUC-ROC: 0.75 [95% CI: 0.69–0.81]). Its predictive power was independent of the patient's initial severity. The clinical characteristics of the frequent exacerbator patient according to this definition varied according to the initial severity of bronchiectasis, presence of systemic inflammation, and treatment.

Conclusions

The combination of two exacerbations or one hospitalization per year is the definition of frequent exacerbator patient that has the best predictive value of mortality independent of the initial severity of bronchiectasis.